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Common musculoskeletal conditions Flashcards

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1
Q

Clavicle fracture: most common in who?

A

Children and as birth trauma

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2
Q

Clavicle fracture: cause?

A

Fall on outstretched hand or direct trauma to shoulder

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3
Q

Clavicle: weakest points?

A

At the junction of middle and lateral thirds

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4
Q

Clavicle: most common fractured segment?

A

Middle third

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5
Q

Clavicle fracture: presentation?

A

Shoulder drop, shortened clavicle

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6
Q

Why is the lateral fragment of a fractured clavicle depressed?

A

Arm weight

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7
Q

By what is the lateral fragment of a fractured clavicle medially rotated?

A

Arm adductor, e.g. pectoralis major, deltoid

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8
Q

What causes Guyon canal syndrome?

A

Compression of ulnar nerve at wrist
Fractured hook of Hamate

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9
Q

In who is Guyon canal syndrome classically seen?

A

Cyclist due to pressure on handlebars

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10
Q

Which syndrom is caused by compression of the ulnar nerve at the wrist?

A

Guyon canal syndrome

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11
Q

What causes carpal tunnel syndrome?

A

Compression of median nerve in carpal tunnel (between transverse carpal ligament and carpal bones)

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12
Q

What are the symptoms of CTS?

A

Paresthesia, pain, numbness in distribution of median nerve

Thenar eminance athropy

Sensation spared

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13
Q

Why is sensation spared in CTS?

A

Palmar cutaneous branch enters hand external to carpal tunnel

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14
Q

What syndrome is caused by entrapment of median nerve between transverse carpal ligament and carpal bones?

A

CTS

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15
Q

What is the Tinel sign?

A

Percussion of wrist causes tingling -> CTS

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16
Q

What is the Phalen maneuver?

A

90 degrees flexion of wrist 1>min causes tingling -> CTS

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17
Q

How to test for CTS?

A

Tinel and Phalen

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18
Q

What is CTS associated with?

A

Pregnancy (due to edema)
RA
Hypothyriodism
Diabetes
Acromegaly
Dialysis-related amyloidosis

Repetitive use

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19
Q

Metacarpal neck fracture (boxer’s fracture): cause?

A

Direct blow with a close fist (e.g. punching a wall)

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20
Q

Metacarpal neck fracture: in which metacarpal most common?

A

5th

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21
Q

What is most commonly caused by a direct blow with a close fist?

A

Metacarpal neck fracture or ‘boxer’s fracture’

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22
Q

Iliopsoas abscess: what is it?

A

Collection of pus in iliopsoas compartment

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23
Q

Iliopsoas abscess: cause?

A

Hematogenous spread or adjacent structures

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24
Q

From which adjacent structures can an iliopsoas abscess be caused?

A

Vertebral osteomyelitis
Tuberculous spondylitis (Pott’s disease)
Pyelonefritis

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25
Iliopsoas abscess: associations?
Crohn, diabetes, immunocrompromised states
26
Iliopsoas abscess: which bacteria most commonly isolated?
S. Aureus, but also 2nd to TB
27
Iliopsoas abscess: findings?
Flank pain, fever, flank bulge, inguinal mass, positive psoas sign
28
Flank pain, fever, flank bulge, inguinal mass, positive psoas sign -> suggestive of what?
Iliopsoas abscess
29
What is a positive psoas sign?
Hip extension exacerbates lower abdominal pain
30
Iliopsoas abscess: lab findings?
Leukocytosis
31
Iliopsoas abscess: CT/MRI findings?
Focal hypodens (dark) lesion within the muscle plane
32
Iliopsoas abcess: treatment?
AB based on culture, CT-guided percutaneous drainage (PCD), or surgical drainage
33
What is and unhappy triad of the knee?
Damage to ACL, MCL, and medial meniscus (attached to MCL)
34
How is unhappy triad of knee commonly caused?
Lateral force impacting the knee when foot is planted on the ground (e.g. during contact sports)
35
Unhappy triad: presentation?
Acute pain and signs of joint instability
36
Prepatellar bursitis: what is it?
Inflammation of prepatellar bursa in front of the knee cap
37
Prepatellar bursitis: cause?
Repetitive trauma or pressure from excessive kneeling (housemaid's knee)
38
Politeal cyst (Baker cyst): what is it?
Popliteal fluid collection, commonly communicating with synovial joint
39
Popliteal cyst: in which bursa?
Gastrocnemius - semimembranosus
40
Popliteal cyst: related to which diseases?
Chronic joint disease; e.g. osteoarthritis and RA
41
Swelling in back of knee: what is this suggestive of?
Popliteal cyst/Bakers cyst
42
Costochondritis: what is it?
Inflammation of costochondral of costosternal junctions (may be due to minor trauma)
43
Costochondritis: presentation?
Pleuritic chest pain and focal tenderness to palpation
44
What is pleuritic chest pain?
Sharp chest pain that worsens during breathing
45
Costochondritis: in who is it more common?
Young females
46
Costochondritis: treatment?
analgesics, stretching therapy
46
What may costochondritis mimic?
MCI, pleuritis, PE
47
Pleuritic chest pain and focal tenderness of costochondral and costosternal junctions to palpation: what can it be?
Costochondritis DD MCI, PE, pleuritis
48
De Quervain tenosynovitis: what is it?
Non-inflammatory thickening of abductor pollicis longus and extensor pollicis brevis tendons
49
De Quervain tenosynovitis: which test?
Finkelstein (pain at radial styloid with active/passive stretch of thumbs tendons)
50
What is the Finkelstein test?
Active/passive stretch of thumbs tendons Positive if pain at radial styloid
51
Who is at increased risk of De Quervain tenosynovitis?
New mothers (lifting of baby) Golfers Racquet sport players Thumb texters
52
Positive Finkelstein test is suggestive of what?
De Quervain tenosynovitis
53
What is non-inflammatory thickening of thumb tendons?
De Quervain tenosynovitis
54
Pain at radial styloid is suggestive of what?
De Quervain tenosynovitis
55
Dupuytren contracture: what is it?
Fibroblastic proliferation and thickening of superficial palmar fascia
56
Fibroblastic proliferation and thickening of superficial palmar fascia: what is this?
Dupuytren contracture
57
Which fascia are typically involved in Dupuytren contracture?
At the base of ring and little fingers
58
Dupuytren contracture: in who most often seen?
Males >50 y/o from Northern European descendent
59
Ganglion cyst: what is this?
Fluid-filled swelling overlying joint or tendon
60
Fluid filled swelling overlying joint or tendon: what is this?
Ganglion cyst
61
Where is ganglion cyst most commonly seen?
Dorsal side of wrist
62
How does a ganglion cyst arise?
From herniation of dense connective tissue
63
What is the natural course of a ganglion cyst?
Resolves spontaneously
64
Iliotibial band syndrome: what is this?
Overuse injury of lateral knee, due to friction of iliotibial band against lateral femoral epicondyl
65
Iliotibial band syndrome: in who occurs this mostly?
Runners
66
Lateral knee pain in runners: what can it be?
Iliotibial band syndrome
67
Limb compartment syndrome: pathofysiology?
Increased pressure in fascial compartment of a limb -> venous outflow obstruction and arteriolar collapse -> anoxia, necrosis and rhabdomyolisis -> acute tubular necrosis
68
What is caused by increased pressure in a fascial compartment of a limb?
Limb compartment syndrome
69
What can cause limb compartment syndrome?
Long bone fractures (e.g. tibia) Reperfusion injury Animal venom
70
Limb compartment syndrome: presentation?
Severe pain and tense, swollen compartments with passive stretch
71
5 Ps of Limb compartment syndrome?
Pulselessness, pain, palor, paresthesia, paralysis
72
Limb compartment syndrome: late findings of irreversible muscle and nerve damage?
Increased serum creatine kinase, motor deficits
73
Medial tibial stress syndrome (shin splints): pathophysiology?
Bone resorption that outpaces bone formation in tibial cortex
74
Medial tibial stress syndrome (shin splints): presentation?
Shin pain and diffuse tenderness
75
Another name of medial tibial stress syndrome?
Shin splints
76
Another name for shin splints?
Medial tibial stress syndrome
77
Medial tibial stress syndrome: in who?
Runners and military recuits
78
Shin pain and diffuse tenderness: suggestive of?
Medial tibial stress syndrome or shin splints
79
Plantar fasciitis: what is it?
Inflammation of plantar aponeurosis characterized by heel pain and tenderness
80
Plantar fasciitis: when is the heel pain worse?
After long periods of inactivity (first steps in the morning)
81
Plantar fasciitis: associated with?
Obesity, prolonged standing or jumping (e.g. dancers, runners), and flat feet
82
Plantar fasciitis: what does often co-exist?
Heel spurs
83
Heel pain and tenderness, worse in the morning. What is this suggestive of?
Plantar fasciitis
84
Temporomandibular disorders: what is it?
Group of disorder affecting the temporomandibular joint (TMJ) and muscles of mastification
85
Temporomandibular disorders: associated with?
TMJ trauma Poor head and neck posture Abnormal trigeminal nerve processing Psychological factors
86
Temporomandibular disorders: presentation?
Dull, constant, unilateral facial pain
87
Temporomandibular disorders: pain worsens with what?
Jaw movement, otalgia, headache, TMJ dysfunction (e.g. limited movement)
88

Musculoskeletal system (17 decks)

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